Provider Demographics
NPI:1114037355
Name:JERSIE, FRANCES (LPC)
Entity Type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:
Last Name:JERSIE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 BELLEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3652
Mailing Address - Country:US
Mailing Address - Phone:973-743-7600
Mailing Address - Fax:
Practice Address - Street 1:324 BELLEVILLE AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3652
Practice Address - Country:US
Practice Address - Phone:973-743-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC1385101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional